Mapping the Comorbidome in Chronic Obstructive Pulmonary Disease: Prevalence and Mortality Risk in a Colombian Cohort.

Background/

Objectives

Chronic Obstructive Pulmonary Disease (COPD) is frequently associated with multiple comorbidities that influence prognosis. The comorbidome is a graphical representation of both the prevalence and strength of association of each comorbidity with COPD, allowing rapid identification of the most relevant risk factors. The aim of this study was to evaluate the association between comorbidities and mortality in patients with COPD using a comorbidome approach.

Methods

We conducted a retrospective cohort study of 500 patients aged ≥40 years with COPD treated between 2005 and 2020 at Clínica Universidad de La Sabana (Chía, Colombia). Demographic variables, comorbidities, and mortality were recorded. The prevalence of each comorbidity was expressed as a percentage, and their association with mortality was assessed using odds ratios (OR) derived from univariate contingency tables with 95% confidence intervals (95% CI). The comorbidome was constructed by plotting the inverse odds ratio (1/OR) against the prevalence of each condition.

Results

The mean age was 76.6 years (SD 11.3). Overall mortality was 28.4%. The most prevalent comorbidities were hypertension (45.2%) and smoking (38%). Comorbidities significantly associated with mortality in unadjusted analyses included congestive heart failure (OR: 4.28; 95% CI: 2.55-7.18), arrhythmias (OR: 2.86; 95% CI: 1.60-5.13), acute myocardial infarction (OR: 2.58; 95% CI: 1.52-4.38), moderate or severe renal disease (OR: 2.08; 95% CI: 1.07-4.04), peripheral vascular disease (OR: 1.94; 95% CI: 1.10-3.40), and hypertension (OR: 1.66; 95% CI: 1.12-2.46).

Conclusions

The most prevalent comorbidities were hypertension and smoking. However, the conditions significantly associated with mortality in unadjusted analyses were congestive heart failure, arrhythmias, acute myocardial infarction, moderate or severe renal disease, peripheral vascular disease, and hypertension.